Efficacy of disulfiram and cognitive behavior therapy in cocaine-dependent outpatients - A randomized placebo-controlled trial
Efficacy of disulfiram and cognitive behavior therapy in cocaine-dependent outpatients - A randomized placebo-controlled trial
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DOI：
10.1001/archpsyc.61.3.264
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发表时间：
2004-03-01
影响因子：
--
通讯作者：
Rounsaville, BJ
中科院分区：
文献类型：
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作者：
Carroll, KM;Fenton, LR;Rounsaville, BJ
背景：双硫仑已成为一种治疗可卡因依赖的有希望的药物，但尚未对一般可卡因使用者进行评估。目的：比较双硫仑治疗与安慰剂治疗在减少可卡因使用方面的效果，并比较两种积极行为疗法——认知行为疗法（CBT）和人际心理治疗（IPT）在减少可卡因使用方面的效果。设计：随机、安慰剂对照、双掩码（药物条件）、因子（2 × 2）试验，有4种治疗条件：双硫仑加CBT、双硫仑加IPT、安慰剂加CBT和安慰剂加IPT。设置：以社区为基础的门诊药物滥用治疗项目。患者：共有121人符合当前可卡因依赖的标准。干预措施：患者接受双硫仑（250mg /d）或相同胶囊的安慰剂。使用核黄素标记程序监测药物依从性。两种行为疗法（CBT和IPT）都是手工指导的，并在12周的时间里进行单独的治疗。主要结局指标：对自述可卡因使用频率和尿液毒理学筛查结果进行随机回归分析。结果：服用双硫仑的受试者比服用安慰剂的受试者减少了可卡因的使用，服用CBT的受试者比服用IPT的受试者减少了可卡因的使用
Context: Disulfiram has emerged as a promising treatment for cocaine dependence, but it has not yet been evaluated in general populations of cocaine users.Objectives: To compare the effectiveness of disulfiram therapy with that of a placebo condition in reducing cocaine use and to compare the effectiveness of 2 active behavioral therapies-cognitive behavior therapy (CBT) and interpersonal psychotherapy (IPT)-in reducing cocaine use.Design: Randomized, placebo-controlled, double-masked (for medication condition), factorial (2 X 2) trial with 4 treatment conditions: disulfiram plus CBT, disulfiram plus IPT, placebo plus CBT, and placebo plus IPT.Setting: A community-based outpatient substance abuse treatment program. Patients: A total of 121 individuals meeting the criteria for current cocaine dependence.Interventions: Patients received either disulfiram (250 mg/d) or placebo in identical capsules. Medication compliance was monitored using a riboflavin marker procedure. Both behavioral therapies (CBT and IPT) were manual guided and were delivered in individual sessions for 12 weeks.Main Outcome Measures: Random regression analyses of self-reported frequency of cocaine use and results of urine toxicology screens.Results: Participants assigned to disulfiram reduced their cocaine use significantly more than those assigned to placebo, and those assigned to CBT reduced their cocaine use significantly more than those assigned to IPT (P